Wounds that won't heal could be symptom of cancer

Health Care Hotline may have helped alert patients about potentially dangerous conditions on Saturday, with callers advised to see doctors about several chronic conditions.

The Deseret News/Intermountain Health Care feature racked up calls from such scattered locations as Taylorsville; Layton; Hyde Park, Cache County; Sandy; North Ogden; American Fork; Riverton; Salt Lake City; Provo; Spanish Fork; and Coalville. Experts fielding the questions were Dr. Lin Weaver, medical director of LDS Hospital's Comprehensive Wound Care and Hyperbaric Medicine Center, and Sue Churchill, a nurse practitioner at the center.Because the center specializes in helping difficult wounds heal, many of the calls concerned sores that were not getting better. Callers who were advised to see a doctor immediately complained of a deep wound in the foot that won't heal, a sore on the nose that bleeds daily, a breast cancer operation that isn't recovering well and a sore at the side of the mouth.

One man reported that for months he's had a non-healing sore on the corner of his mouth. Weaver advised him to get it checked by a physician because of the possibility it could be cancer.

Another told Weaver that diabetes caused a wound in his foot that had not healed for two years. The wound was about four inches long by a quarter-inch to a half-inch deep. The man's big and little toes were amputated and some foot bones were removed. "He's on and off antibiotics," Weaver said.

The man went to a vascular surgeon, who thought the blood flow to his foot was all right. The patient's internist then sent him to an orthopedic surgeon, who advised amputating the foot.

Both the doctor of internal medicine and the patient were against removing the foot. The doctor has continued to treat the wound with antibiotics. "He (the patient) described changing dressings multiple times a day because of all the drainage," Weaver said.

"I recommended that he come see us." The patient agreed.

The center will evaluate the wound and see if treatment in a hyperbaric chamber would help. The chamber allows patients to breathe pure oxygen under pressure, which helps bring more oxygen through the blood stream and to the injury. A good oxygen supply is essential for prompt healing.

"We would measure oxygen levels in the foot," he said. Other studies would be carried out. Perhaps the patient would be advised to have a vascular surgeon take another look at the limb. Perhaps a plastic surgeon could evaluate whether a skin graft could help close the wound.

A woman told Churchill that last year she had a cancerous lump removed from her breast and received radiation therapy. She developed an infection and the site had to be cleaned out. But the incision for the latter operation hasn't yet recovered.

"She said it's been slowly healing, but her family thinks not fast enough," Churchill said. Perhaps, the nurse said, the woman may be a candidate for hyperbaric treatment, or maybe she needs a different type of ointment or dressing to help the wound close.

Churchill advised her to have it evaluated at the center. Meanwhile, the patient was going to visit a doctor this month, and Churchill said she should have the breast checked to make sure that cancer hasn't returned.

Another woman who called Churchill has a sore on her nose that keeps bleeding. She has had the sore for 12 years. An ear, nose and throat specialist has been cauterizing it and giving her ointment.

"I told her I would be worried that there could be cancer there," Churchill said. She advised her to have a biopsy taken from the site. "It's always a good idea to get a second opinion about that," she said.

A 67-year-old woman told Weaver she has an ulcer on her ankle. She had surgery to drain the ulcer and close it.

"The wound is beginning to pull apart," he said. "It's not healing right, so she is wondering about hyperbaric oxygen."

Often, diabetic patients or others with circulation problems in their feet develop sores that don't heal properly, and sometimes the hyperbaric chamber can help them. "I said, yeah, it might be quite reasonable" to have the therapy.

He advised the woman to show her doctor a Deseret News article about the hyperbaric chamber and to discuss whether treatment there might be appropriate.

The Health Care Hotline is a free public service of the Deseret News and IHC. On the second Saturday of every month, callers throughout the region reach health specialists. The subjects differ month to month.